MEDICARE: LIFESAVERS SUPPORT SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	305S00000X	Point of Service
2	310400000X	Assisted Living Facility
3	311Z00000X	Custodial Care Facility
4	311ZA0620X	Adult Care Home Facility
5	314000000X	Skilled Nursing Facility
6	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
7	174200000X	Meals Provider
8	251B00000X	Case Management Agency
9	251E00000X	Home Health Agency
10	251G00000X	Community Based Hospice Care Agency
11	253Z00000X	In Home Supportive Care Agency
12	332U00000X	Home Delivered Meals
13	343900000X	Non-emergency Medical Transport (VAN)
14	385H00000X	Respite Care
15	104100000X	Social Worker

General Provider Information

NPI Number	:	1992645790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFESAVERS SUPPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	31132 N PARK DR
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-1450
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16631 SALEM ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48219-3697
Country	:	US
Telephone Number	:	313-779-5701
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ERICA WOODS
Credential	:
Telephone Number	:	313-779-5701

Provider Enumeration Date	:	03/31/2026
Last Update Date	:	04/20/2026

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